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[阿根廷队列中通过辅助生殖技术受孕的妊娠的产科和新生儿结局]

[Obstetric and neonatal outcomes in pregnancies conceived by assisted reproductive technology in an Argentine cohort].

作者信息

Diez Brito Macarena, Sevillano Gonzalo, Negri Florencia, Mongelos Milagros, Izbizky Gustavo

机构信息

Hospital Italiano de Buenos Aires.

Instituto Universitario Hospital Italiano.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2024 Dec 13;81(4):734-751. doi: 10.31053/1853.0605.v81.n4.44425.

Abstract

INTRODUCTION

Since its introduction in clinical practice in 1981, pregnancies conceived by assisted reproductive techniques (ART) are an increasing proportion of all pregnancies, presenting particular challenges.

OBJECTIVE

To analyze the maternal-fetal outcomes of pregnancies conceived by ART in a single center in Argentina. Material and methods: Retrospective cohort of pregnancies conceived by ART who attended their delivery in a private university hospital through a review of records.

RESULTS

The incidence of composite primary maternal outcome was 40,1% (282/703), with hypertensive disease of pregnancy (21%) being the most frequent presenting pathology.In the multivariate analysis, age > 40 (OR 2,79; 95%CI: 1,82-4,26), chronic hypertension (OR 10,59; 95% CI: 2,81-39,86), twin pregnancy (OR 8,94; 95% CI: 5,39 – 14,80) and oocyte donation (OR 1,54; 95% CI: 1,04 – 2,27) were significantly associated with the maternal primary outcome. The incidence of the composite neonatal fetal primary outcome was 56,7% (468/824), with a prematurity rate of 34,5% (252/803). In the multivariate analysis of the composite outcome of the neonatal fetus, twin pregnancy (OR 7,08; 95% CI: 3,48 – 14,39) and other complications related to prematurity were statistically significantly associated with the composite outcome.

CONCLUSIONS

Pregnancies conceived by ART show a significant increase in adverse maternal outcomes, mainly hypertension, and fetal and neonatal outcomes (prematurity, malformations, and admission to the intensive care unit).

摘要

引言

自1981年辅助生殖技术(ART)应用于临床实践以来,通过该技术受孕的妊娠在所有妊娠中所占比例日益增加,带来了特殊挑战。

目的

分析阿根廷某单一中心通过ART受孕的妊娠的母胎结局。材料与方法:通过回顾记录,对在一家私立大学医院分娩的ART受孕妊娠进行回顾性队列研究。

结果

复合主要孕产妇结局的发生率为40.1%(282/703),妊娠高血压疾病(21%)是最常见的病理表现。在多因素分析中,年龄>40岁(OR 2.79;95%CI:1.82 - 4.26)、慢性高血压(OR 10.59;95%CI:2.81 - 39.86)、双胎妊娠(OR 8.94;95%CI:5.39 - 14.80)和卵母细胞捐赠(OR 1.54;95%CI:1.04 - 2.27)与孕产妇主要结局显著相关。复合新生儿胎儿主要结局的发生率为56.7%(468/824),早产率为34.5%(252/803)。在新生儿胎儿复合结局的多因素分析中,双胎妊娠(OR 7.08;95%CI:3.48 - 14.39)和其他与早产相关的并发症与复合结局在统计学上显著相关。

结论

通过ART受孕的妊娠显示出不良孕产妇结局显著增加,主要是高血压,以及胎儿和新生儿结局(早产、畸形和入住重症监护病房)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e44/11905777/605d38533754/1853-0605-81-4-734-g001.jpg

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